Ten things you can do to deal with depression

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So you find these dark periods are here again.  You may try many things which help somewhat but depression keeps coming around.  You don’t want it, and you don’t like it.  But when it is here anyway, here are some tips which may help:

1. Allow yourself to feel the way you feel.

Society and social media would have you believe that something is wrong with you if you feel depressed.  Of course these feelings are unpleasant and you don’t have to like them, but they  are normal, common and occur to everyone to various degrees.  Feeling depressed is unpleasant enough, but in addition you may feel guilty, angry, sad or anxious about being depressed.  Just being ok about whatever  you feel can lessen these secondary emotions.

2. Become aware of your thoughts and don’t take them all as gospel.

Taking your thoughts at face value would be like heeding every piece of advice and advertisement you hear on the radio.  It’s more useful to know you are listening to the radio and hearing an advertisement.  You have thoughts but your thoughts are not you.  Many of our thoughts are automatic and just pop up, and may not be that helpful.  Seeing  your thoughts  for what they are gives you a chance to decide which ones to pay attention to.

3. Put your efforts towards changing your actions rather than your thoughts and feelings.

We have the idea that we need sort out our thoughts and feelings first before we can make changes to our lives.  The research shows that it is the other way around, that the only part you can control are your actions .  Your thoughts and feelings will likely change if you engage in different actions.

4. Bring your attention to the present moment.

When you have lots of difficult thoughts and feelings, they can demand all your attention so that you go about your day in on auto-pilot. Expand your awareness  to  include what there is right here and now, using your five senses, and notice small details with openness and curiosity.  So you may notice feeling sad, as well as apprehensive as well as doubtful, as well as hear birds, see trees, taste your sandwich, see your friend’s face……

5. Set time aside to practice mindfulness.

There is nothing magical about mindfulness.  It is paying attention in a purposeful and open way. It is a skill that needs repeated practice, like running or swimming. You can practice mindfulness doing every day activities such as having a cup of coffee, brushing your teeth, washing dishes, walking and driving.  There are many great apps available with audio guides to assist you, including “Smiling Mind” and “ACT Companion”.

6. Connect with what is important to you.

Sometimes being depressed is so unwanted that you spend all your efforts trying to feel better, thereby behaving in ways that are at odds with what is important to you.  You may value meaningful relationships, nature, learning, or helping others.  Find opportunities to put these values into actions.  The things you care deeply  about are often on the flip side of what causes you pain or distress.  You may feel guilty about withdrawing from your family or not turning up to work – the flip side of that may be because you value connection and contribution.

7. Take lots of small steps repeatedly to build helpful habits.

Make changes in your behaviour in the direction of what you value, no matter how small that seems.  Lots of small actions in the right direction will be more helpful than setting big unrealistic goals, then feeling overwhelmed and guilty when you don’t do them.  Build helpful habits over time that will help you handle depression in the future when it comes around again.  Some of the most helpful habits are exercise, healthy eating and meaningful relationships, and they all take time and repeated actions.

8. Be grateful for what you do have, do something for others.

Life can be extremely challenging at times, but in the midst of that we can usually find things that we can be grateful for ways to help others.  Research shows that actively fostering  gratitude and compassion can counteract depression, and that doing something for others boosts the giver’s happiness even more than the receiver’s.

9. Cut yourself some slack and be kind to yourself.

Many of us find it easy to be kind to others, but find it hard to cut ourselves some slack.  When you beat yourself up about something, imagine how you would react if you were listening to a friend telling you their struggles, and see if you can give yourself the kindness you would give to a friend.

10. Seek professional help if you are struggling.

This can include a whole range of allied health and medical professionals.  However be aware of quick fixes or grand promises. There is a role for prescription medications from your GP or psychiatrist.  However the evidence is that for mild to moderate depression, there are many other treatment options that work better than or as well as medication.  They include exercise, relaxation techniques, and a whole range of psychological treatments including cognitive behaviour therapy and mindfulness-based therapies such as Acceptance and Commitment Therapy.  The advantage of the non-drug treatments are that you have skills you can use throughout your life, and without the side effects.  In the end it is about respecting your preference and helping you be aware of all your options, and if required, using medications in the safest possible way while minimising side effects.

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Where does Suffering Come From?

By Dr. Rob Purssey

The ACT model predicts that a lot of suffering is caused by becoming entangled in difficult and painful thoughts and feelings, and then is further exacerbated by trying to push those thoughts and feelings away.

In ACT terminology getting caught up with difficult thoughts is called ‘cognitive fusion’, and trying to push unwanted thoughts and feelings away is called ‘experiential avoidance’. Fusion with difficult thoughts and struggle with painful feelings are very likely to be key processes in all human psychological struggle. What can we do to keep moving forward when facing pain and suffering in our lives? More than a thousand studies suggest that a major part of the answer is learning ACT – psychological flexibility skills.

An exciting recent study of a large sample of community adults recruited via the internet (N=955) examined the interaction between cognitive fusion and experiential avoidance in relation to psychological distress – and found, as predicted by the model:

“The predicted interactive effect was found across all four symptom measures, with the significant positive association between cognitive fusion and symptom measures being strongest at higher levels of experiential avoidance. These results provide support for proposals that individuals with high cognitive fusion and high experiential avoidance may be particularly prone to experiencing psychological distress.”

You can check out the study here: http://www.sciencedirect.com/science/article/pii/S2212144716300035

ACT aims to help people to more effectively handle difficult thoughts and feelings by learning key psychological flexibility skills, and with self compassion and resilience, keep doing what is important, even with their  tough inner experiences. Our skills coaching at the Brisbane ACT Centre directly addresses both cognitive fusion and experiential avoidance, and our resources page is a great place to start.

Directly undermining fusion with defusion, and directly increasing psychological flexibility with willingness and acceptance – key ACT skills – can quickly improve your life, easing struggling with suffering, enhancing more vital living. If that interests you get in touch with our friendly staff at the Brisbane ACT Centre today.

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Abstract

http://www.sciencedirect.com/science/article/pii/S2212144716300035

Acceptance and Commitment Therapy, a popular transdiagnostic treatment approach, is based on the central tenant that human suffering develops and is exacerbated by psychological inflexibility. Cognitive fusion and experiential avoidance are two interrelated processes central to psychological inflexibility. Despite substantive theoretical rationale that these two processes impact one another’s association with emotional distress and psychopathology, the interaction between cognitive fusion and experiential avoidance in relation to psychological distress has yet to be empirically examined in the extant literature. As such, we examined this interactive effect in relation to four indices of psychological distress (anxiety, depression, stress, and posttraumatic stress) in a large sample of community adults recruited via the internet (N=955). The predicted interactive effect was found across all four symptom measures, with the significant positive association between cognitive fusion and symptom measures being strongest at higher levels of experiential avoidance. These results provide support for proposals that individuals with high cognitive fusion and high experiential avoidance may be particularly prone to experiencing psychological distress.

How to Reduce Your Work Stress & Burnout Risk Using ACT

By Dr. Rob Purssey

Nursing is often a high stress profession, with difficult hours, systems, patients, colleagues, bureaucracy – you name it! These challenges mean that nurses and other health workers are more susceptible to burnout than other low stress professions, but is there anything we can do to help health workers lower their stress?

One of the key parts of burnout for health workers are the psychological effects of working with difficult clients. In particular “stigmatising attitudes” are particularly difficult for drug abuse counsellors. If we could decrease these psychological effects for health workers we could also decrease their stress, and degrees of burnout.

An interesting study compared the impact of ACT, multicultural, and educational training on professional burnout and stigmatizing attitudes amongst drug abuse counselors.

The ACT intervention significantly reduced stigma at follow-up and burnout at post-intervention and follow-up. In addition, reductions in burnout at follow-up significantly exceeded those attained through multicultural training. Changes in the ACT condition were mediated by changes in the believability of stigmatizing attitudes.

A study with social workers showed, amongst those significantly stressed, ACT significantly decreased levels of stress and burnout, and increased general mental health compared to a waiting list control.

The specific ACT intervention the study used was six 2-hour group sessions. The intervention included information about stress and relevant lifestyle factors (e.g. work-life balance, sleep, and exercise), behavior change strategies, communication and assertiveness skills, and training in ACT techniques for managing stressful thoughts and feelings, values clarification, and mindfulness practice.

To shorten that up, the just 12 total hours of intervention covered:

-information about stress, sleep, exercise

behaviour change strategies in communication and assertiveness

ACT skills defusion, acceptance, values focus and mindfulness

This recent study is very important for our frontline healthcare workers –the intervention resulted in increased mindful awareness and decreased experiential avoidance, as well as decreased perceived stress and burnout. Levels of mindful awareness and perceived stress were sustained at follow-up.

Learning ACT skills can help to significantly reduce stress for frontline health workers, and could be an effective tool to decrease stress for many other proffessions. Learning ACT skills can be easy, get started with our ACT Fundamentals resources page.

Check out the study here.

Using Cutting Edge Virtual Reality Technology to Treat Depression

By Dr. Rob Purssey

Self criticism can be a helpful tool but for many people it can be damaging, pulling us away from the things that matter most to us or slowing us down with anxiety or depression. A wealth of research shows however that we can learn to manage overly self critical thoughts and feelings using self compassion.

However, many of us are resistant to self-compassion.

Check out this awesome study in which they used an immersive virtual reality scenario. Participants interacted compassionately with a crying virtual child while embodied in a virtual adult body.

In the second phase, one group of participants then embodied the child body and could experience a recording of their compassionate gestures and words being delivered to them from this (child) embodied first-person perspective.

By having participants embody an adult and then a child virtual body in succession, our scenario effectively provided a self-to-self situation enabling participants to deliver compassionate sentiments and statements to themselves.

Fascinating stuff.

Participants of the study had three 8 minute virtual reality exposures each one week apart, at the end of the three experiences. 60% of the 15 participants reported decreased depression symptoms a month later.

Self compassion is a skill that can be learned to help live life more meaningfully, and is a core part of acceptance and commitment therapy.

http://www.spring.org.uk/2016/02/depression-treated-24-minutes-new-therapy.php

Full study here – http://bjpo.rcpsych.org/content/2/1/74